微球联合碘油栓塞治疗肝癌的近期疗效分析  

TACE by using microspheres and lipiodol for the treatment of hepatocellular carcinoma: analysis of short-term efficacy

作　　者：游建雄[1] 王精兵[1] 艾松涛[2] 范新东[1] 郑连洲[1] 苏立新[1] 温明哲 杨西涛[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院介入科,201999 [2]上海交通大学医学院附属第九人民医院放射科,201999

出　　处：《介入放射学杂志》2017年第6期531-534,共4页Journal of Interventional Radiology

摘　　要：目的评价微球联合碘油栓塞肝细胞癌(HCC)的近期疗效及安全性。方法 87例病理证实的肝细胞癌患者随机分为两组,微球组,采用粒径100~300μm的Embosphere微球联合碘化油栓塞;对照组,采用粒径350~560μm明胶海绵颗粒联合碘化油栓塞。术后观察生化及影像学变化,分析临床疗效与不良反应。结果共87例患者行TACE治疗,微球组44例,对照组43例,治疗后微球组疾病获益率与AFP下降较对照组更明显(P<0.05),肝功能指标与术前比较差异无统计学意义(P>0.05),6个月的随访期间微球组介入治疗平均次数少于对照组(P<0.05)。两组患者6、12和18个月生存率差异无统计学意义(P>0.05)。结论微球联合碘化油栓塞HCC安全,较明胶海绵联合碘化油栓塞近期疗效更明显,能减少患者治疗次数,栓塞前应注意肝动脉门静脉瘘的预处理及微导管的超选。Objective To evaluate the short-term curative effect and the safety of transcatheter arterial chemoembolization （TACE） therapy by using microspheres and lipiodol for hepatocellular carcinoma （HCC）. Methods A total of 87 patients with pathologically proved HCC were randomly divided into the study group （n=44, using embospheres of 100-300 μm in diameter together with lipiodol） and the control group （n=43, using gelfoam particles of 350-560 μm in diameter together with lipiodol）. Postopertaive biochemical （liver function and AFP） findings and imaging （CT and/or MRI） manifestations were recorded, and the clinical efficacy and adverse reactions were analyzed. Results TACE was performed in all 87 patients. After the treatment, both the disease benefit rate and the postoperative reduction in AFP level in the study group were remarkably better than those in the control group （P〈0.05）, but postoperative liver function indexes were not significantly different from the preoperative ones （P〉0.05）. The average number of interventional therapy within the follow-up period of 6 months in the study group was smaller than that in the control group （P〈0.05）. No statistically significant differences in 6-, 12- and 18-month survival rates existed between the two groups （P〉0.05）. Conclusion In treating HCC, TACE by combination use of microspheres and lipiodol is safe, its short-term curative effect is more obvious than TACE by combination use of gelfoam particles and lipiodol, and it can reduce the times of interventional procedure. Before TACE, careful planning of the pre-treatment of hepatic artery-portal vein fistula and the superselective catheterization with micro catheter should be taken into consideration. （J Intervent Radiol, 2017, 26： 531-534）

关 键 词：微球 碘化油 经导管动脉化疗栓塞术 肝细胞癌 介入放射学 

分 类 号：R735.7[医药卫生—肿瘤]